Meet asthma diganostic criteria (bronchodilator reversibility or positive methacholine challenge), with modest obstruction and some evidence of decreased FVC and DLCO, and elevated blood eosinophils or exhaled NO despite prednisone
Often adult-onset or adult worsening
Associated with autoimmune family history (70%)
Can only be diagnosed by biopsy via VATS
Sinus CT often demonstrates sinusitis and chest CT is often normal
Treatment is with alternative antiinflammatory medications (MTX, mycophenolate, azathioprine) which may improved FEV1 and decrease exacerbations
Differential Diagnosis
Asthmatic granulomatosis (Wenzel)
References